Though intersex people have existed throughout all of human history, the trend of corrective surgeries on infants and children born with intersex traits is only around 60 years old, achieving wide popularity in that time. The surgeries are purely cosmetic and are rarely done out of medical necessity, and can often have extremely harmful effects. Though the practice is slowly falling out of favor, mostly thanks to the Human Rights Watch and advocacy groups like InterACT, it is still incredibly common for doctors and surgeons to recommend and perform “normalizing” surgeries on completely healthy babies and children. Because of a societal obsession with a sex binary (referring to a need to identify people as male or female based on genitalia), the topic of any type of medical deviancy is seldom discussed, which means when people find out their child is intersex they are often told that their child is abnormal and will be ostracized, requiring surgery to “fit in.” Not only does the process reinforce the incorrect idea that the two sexes are absolute and all-encompassing, but it also causes irreversible harm to people’s bodies and minds.
Approximately 1.7% of the world’s population is intersex. To put that in perspective, only 2% of the population are redheads, so someone is almost as likely to be born with intersex traits as they are to be born with red hair. Being born intersex often refers to the presence of anatomy or chromosomes that differ from social expectations of the two binary sexes. One of the most common conditions leading to intersex traits is Congenital Adrenal Hyperplasia (CAH), which causes an infant to be born with XX chromosomes, but lacking an enzyme vital to producing androgens, leading to an enlarged clitoris and fused labia. Similarly, Testosterone Biosynthetic Defects (TBD) decreases the amount of an enzyme vital in producing testosterone, which leads individuals with XY chromosomes to be born with ambiguous genitals, often assumed to be biologically female. Androgen Insensitivity Syndrome (AIS) causes people with XY chromosomes the inability to react to androgens, often leading to ambiguous genitals, but irregular development during puberty, such as the growth of breasts, but the lack of menstruation. There are over 30 different conditions that can cause intersex traits, making the concept of “being intersex” a huge spectrum. Sometimes being born intersex can be visually obvious and apparent at birth, and sometimes it isn’t.
For instances when intersex traits aren’t visually obvious, diagnosis and treatment will usually occur during puberty, when a child may begin to notice developmental irregularities. For infants born with obvious signs of intersex conditions and traits, however, corrective surgeries are often performed to “normalize” that infant and force them to conform to a sex binary, even if it is medically reckless and harmful both physically and psychologically. Infants can have gonads removed, leading to sterilization and forcing that person to live their entire life on hormone replacement medication and therapy. Other surgeries attempting to alter an infant’s genitals can lead to permanent nerve damage, scarring, numbness, and trauma. Most corrective surgeries are either done to allow for heterosexual intercourse, or to allow a child to conform to traditional sex expectations. Corrective surgeries often lead to assigning an incorrect gender and sex identity before a child is old enough to understand their own body and conscious.
These surgeries are seldom based on necessity, and are often done hastily and without proper education or understanding. Many hospitals now have a DSD (differences of sex development) team comprised of healthcare providers, pediatricians, and psychologists meant to help families and their doctors understand their child’s intersex conditions, and aid them in making a decision that prioritizes their child’s wellbeing. While many doctors have now begun to understand that a child’s gender and sex identity are their decision alone, most doctors are still performing cosmetic surgeries with the idea that it will help the child live a “normal” life. However, doctors who perform corrective surgeries don’t take a child’s psychological and physical health into account, and open the door to dysphoria and pain, when realistically that child would have had an incredibly happy and healthy life, had their doctor prioritized their wellbeing over the need to conform.
To make matters worse, parents are often given misleading information about their child’s body. Parents are often rushed into making a decision, are told being intersex is life threatening, or are guilted out of asking questions or protesting. Often times, doctors tell parents that their child needs a surgery to avoid being bullied, or because then later in life they will be able to have “normal” relationships. What parents aren’t told, however, is that corrective surgeries are usually only for cosmetic purposes, often lead to sterilization and infertility, and are often based on a doctor’s best guess as to what gender that child will end up identifying as. For example, there is no universal method doctors adhere to to assign a newborn a sex, so when a doctor can’t clearly tell what sex an infant has, they’ll make an educated guess. This “educated guess” can lead to medically, and surgically, assigning the wrong sex to a child, before they are given the chance to make that decision for themselves. According to the Human Rights Watch, the odds of assigning the wrong sex can be up to 40%, which means that up to 40% of people with intersex traits and conditions are being surgally assigned a sex that does not match their gender, all because a doctor made a bad guess.
Though much of this problem lies in doctors and surgeons making thoughtless decisions, a lot of blame lies in our societal obsession with a sex binary. We can accept that earthworms have both male and female sex organs in their bodies. We can accept that bearded dragons can be born with male chromosomes, but develop female genitalia later in life. We can accept that birds don’t have our X or Y chromosomes, but instead have Z and W chromosomes. Scientifically, we can accept that sex doesn’t always appear as a binary characteristic in nature, and yet we struggle accepting that same idea for humans. We know that humans can safely and naturally exist with a combination of sex organs and chromosomes, though we continue to force non-conforming babies and children through irreversible and harmful surgeries. If we can accept that gender is a social concept and a spectrum, why can’t we do the same for sex? The “sex binary” that we adhere to dictates that people are either biologically male or female, based on them either having a penis or vagina, and usually with XY and XX chromosomes, respectively. If 1.7% of people are born not adhering to this binary, why does it still exist?
The United States must end the practice of corrective surgeries on healthy, intersex children. Thousands of perfectly safe children are forced to go through a traumatic and invasive ordeal, all in the name of “normalizing” something that is already completely natural and harmless. The surgeries strip people with intersex traits of their autonomy and personhood, reducing them down to medical anomolies that must be “fixed” in order to be accepted. In 2015, Malta became the first country to completely ban corrective surgeries, passing legislation to allow each citizen the right to their own gender and sex identity, not based on circumstances of their birth. In 2016, the Chilean government urged doctors to stop performing corrective surgeries on babies with intersex conditions. In 2018, California took steps to condemn the harmful practice, and discourage surgeons from performing surgeries on patients with intersex traits without their explicit consent, and in January of 2020, a bill banning the practice will be revisited.
It’s time that the United States catches up. The practice of corrective surgeries has been cited as a complete human rights violation, with intersex activist and physician Suegee Tamar-Mattis calling it “the biggest ethical disaster in modern medicine of the 2000’s.” When we as a society allow doctors to sterilize someone based on the ambiguity of their genitals, we are allowing a human rights violation. Legislation must be passed to prevent this terrorizing practice from ever happening again. If a child is born with a life-threatening condition due to intersex traits, then of course treatment must be sought out, however being born with intersex traits is very rarely dangerous. Forcing people to take hormone treatment their entire life, or live with irreversible incontinence, or accept a sex identity that doesn’t match their gender identity is completely immoral, and must end.
Roosevelt @ Michigan State University 